Ms Shauna Leigh Ketcham, ASW is a
Social Worker - Clinical based in San Jose, California. Ms Shauna Leigh Ketcham is licensed to practice in * (Not Available) (license number 79168) and her current practice location is
441 Park Ave, San Jose, California. She can be reached at her office (for appointments etc.) via phone at
(408) 287-2460.
NPI number for Ms Shauna Leigh Ketcham is 1841798865 and her current mailing address is 441 Park Ave, San Jose, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1841798865.
Healthcare Provider's Profile
| Full Name | Ms Shauna Leigh Ketcham |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 441 Park Ave, San Jose, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1841798865
- Provider Enumeration Date: 01/24/2018
- Last Update Date: 01/24/2018
Medical Identifiers
Medical identifiers for Ms Shauna Leigh Ketcham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841798865 | NPI | - | NPPES |
| 1871855916 | Other | CA | OUT- PATIENT MENTAL HEATH CENTER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 79168 (California) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 79168 (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Shauna Leigh Ketcham is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Shauna Leigh Ketcham, ASW
441 Park Ave,
San Jose, CA 95110-2615
Ph: () - | Ms Shauna Leigh Ketcham, ASW
441 Park Ave,
San Jose, CA 95110-2615
Ph: (408) 287-2460 |
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